Failure to Ensure Required Interdisciplinary Team Attendance at Care Plan Meeting
Penalty
Summary
The facility failed to implement its policy and procedure regarding care planning by not ensuring that the required interdisciplinary team (IDT) members, including a physician, a registered nurse (RN), and a certified nurse assistant (CNA), were present during a scheduled care plan meeting for a resident. The care plan meeting, held within seven days of the resident's admission as required, was attended only by the resident's power of attorney (POA), an MDS nurse (who was a licensed vocational nurse), an occupational therapist, a social services staff member, and the dietary services supervisor. The absence of the physician, RN, and CNA was confirmed through interviews and review of the IDT Conference Notes. The resident involved had been admitted with multiple diagnoses, including generalized arthritis, syncope, type 2 diabetes mellitus, and depression. The Minimum Data Set (MDS) assessment indicated moderate cognitive impairment and a need for varying levels of staff assistance with activities of daily living such as eating, oral hygiene, showering, personal hygiene, and mobility. Despite these complex needs, the care plan meeting did not include the clinical staff members responsible for the resident's direct care and medical management. Interviews with facility staff, including the Social Services Director, Assistant Director of Nursing, and Administrator, confirmed that the facility's practice was not in alignment with its own policy, which requires the attendance of a physician, RN, and CNA at IDT meetings. The Administrator acknowledged the importance of having these disciplines present to address medical questions, discuss clinical progress, and provide input on daily care routines. The facility's policy, last reviewed shortly before the incident, clearly outlined the required IDT composition, but this was not followed during the resident's care plan meeting.